I had to use the cream on my oldest son but the was when he was a toddler. It worked for him.A friend of mine's other half just had to have the side of his foreskin snipped as it was too tight. He didn't have a full circumcision.If he has a lot of skin then maybe he does need some of it removed. Like Dove said, get a referral to a specialist and they can go through all the options with you.